A5090588741- Renal Transplantation Outcomes and Treatments
- Adolescent and Pediatric Healthcare
- Pharmacological Effects and Toxicity Studies
- Renal Diseases and Glomerulopathies
- Dialysis and Renal Disease Management
- Bipolar Disorder and Treatment
- Renal and Vascular Pathologies
- Childhood Cancer Survivors' Quality of Life
- Pregnancy and Medication Impact
- Nicotinic Acetylcholine Receptors Study
- Medication Adherence and Compliance
- Chronic Kidney Disease and Diabetes
- Transplantation: Methods and Outcomes
- Organ Transplantation Techniques and Outcomes
- COVID-19 Clinical Research Studies
- Receptor Mechanisms and Signaling
- Organ Donation and Transplantation
- COVID-19 Impact on Reproduction
- Mechanical Circulatory Support Devices
- Health Systems, Economic Evaluations, Quality of Life
- Ethics and Legal Issues in Pediatric Healthcare
- Hepatitis C virus research
- Sepsis Diagnosis and Treatment
- Neonatal Health and Biochemistry
- Neurological Complications and Syndromes
Cincinnati Children's Hospital Medical Center
2015-2024
University of Cincinnati Medical Center
2013-2024
University of Cincinnati
2010-2024
University of Michigan
2019
Harvard Pilgrim Health Care
2017
Harvard University
2017
Massachusetts General Hospital
2017
National Institutes of Health Clinical Center
2017
Pediatric Nephrology of Alabama
2012-2015
Arkansas Children's Hospital
2010
There are limited data on the impact of COVID-19 in children with a kidney transplant (KT). We conducted prospective cohort study through Improving Renal Outcomes Collaborative (IROC) to collect clinical outcome about pediatric KT patients. Twenty-two IROC centers that care for 2732 patients submitted testing and outcomes 281 tested SARS-CoV-2 by PCR. Testing indications included symptoms and/or potential exposures (N = 134, 47.7%) per hospital policy 154, 54.8%). Overall, 24 (8.5%)...
We report the discovery and initial characterization of T-superfamily conotoxins. Eight different peptides from five <i>Conus</i>species were identified; they share a consensus signal sequence, conserved arrangement cysteine residues (- -CC- -CC-). found expressed in venom ducts all major feeding types <i>Conus</i>; results suggest that will be large diverse group peptides, widely distributed 500 <i>Conus</i>species. These are likely to functionally diverse; although small (11–17 amino...
In Brief Background Hypertension is a common complication and an important risk factor for graft loss adverse cardiovascular outcomes in pediatric kidney transplantation. Ambulatory blood pressure monitoring (ABPM) the preferred method to characterize status. Methods We conducted retrospective review of large cohort children young adults with transplant estimate prevalence abnormal ambulatory (ABP), assess factors associated ABP, examine whether hypertension worse allograft function left...
We purified and characterized a peptide from the venom of Conus textile that makes normal mice assume phenotype well-known mutant, spasmodic mouse. This "spasmodic" has 27 amino acids, including two γ-carboxyglutamate (Gla) residues. A cDNA clone encoding precursor for was identified; γ-carboxylation recognition signal sequence (γ-CRS) is present in −1 → −20 region precursor. Both γ-CRS position Gla residues mature toxin are notably different other Gla-containing conopeptides. The novel...
Abstract Patient‐identified barriers to immunosuppressive medications are associated with poor adherence and negative clinical outcomes in transplant patients. Assessment of is not part routine post‐transplant care, studies regarding implementing such a process reliable way lacking. Using the Model for Improvement PDSA cycles, we implemented system identify barriers, including patient‐centered design assessment tool, identification eligible patients, clear roles clinic staff, creating...
Masked hypertension is a common complication of pediatric kidney transplantation. While office known to be associated with worse short- and long-term graft function, the role masked in allograft dysfunction not clear. We conducted retrospective cross-sectional analysis 77 consecutive transplant recipients who had routine 24-h ambulatory blood pressure monitoring aims estimate prevalence examine its association function. was defined as systolic or diastolic load ≥25%. Twenty-nine percent...
Tacrolimus is commonly prescribed for immunosuppression, yet it can cause acute and chronic kidney injury. Continuous intravenous nicardipine (CIVN), posttransplant hypertension, inhibits tacrolimus metabolism by cytochrome P450 (CYP) 3A4 could lead to overexposure in patients genetically lacking the alternative pathway metabolism, CYP3A5.We compared maximum 12-hr trough levels (MaxC0) dose-adjusted MaxC0 12 cases treated with CIVN immediately after transplantation 26 controls (no CIVN)....
Ambulatory blood pressure (BP) monitoring (ABPM) is the preferred method to characterize BP status, and its use in kidney transplant recipients increasing. Data on longitudinal ambulatory (ABP) trends pediatric young adult are limited. Retrospective review of a large cohort children adults following transplantation evaluation their ABP status over time associations with any patient clinical characteristics. Two hundred two patients had baseline ABPM available for analysis, 123 them follow up...
Abstract MMF is commonly prescribed following kidney transplantation, yet its use complicated by leukopenia. Understanding the genetics mediating this risk will help clinicians administer safely. We evaluated 284 patients under 21 years of age for incidence and time course ‐related leukopenia performed a candidate gene association study comparing frequency 26 SNP s between cases with controls. matched induction, steroid duration, race, center, age. also impact induction on to in all cases....
Background: Cardiovascular disease is the leading cause of death in children with end-stage renal (ESRD).Isolated aortic dilation (AD) rare children.We aimed to determine prevalence and risk factors for AD ESRD.Methods study design: We reviewed records all ESRD patients followed at our institution from January 2007 October 2012.AD was defined as Z-score > 2 dimension least one following echocardiographic parameters: annulus, root sinus, sino-tubular junction, ,or ascending aorta.Results: The...
Abstract BACKGROUND Amplification of the N‐ myc oncogene is associated with adverse outcomes in common childhood tumor, neuroblastoma. Because transforming properties Myc are related to its ability modulate gene expression, authors used cDNA microarrays identify potential target genes. METHODS Expression levels 4608 genes were analyzed a series neuroblastoma cell lines. Identical analyses performed panel medulloblastoma lines c‐Myc targets and determine extent which N‐Myc shared. Comparisons...
The purpose of this study was to develop a population pharmacokinetic and pharmacodynamic (PK-PD) model for mycophenolic acid (MPA) in paediatric renal transplant recipients the early post-transplant period.A total 214 MPA plasma concentrations-time data points from 24 patients were available PK development. In 17 out patients, inosine monophosphate dehydrogenase (IMPDH) enzyme activity measurements (n = 97) peripheral blood mononuclear cells PK-PD modelling. developed using non-linear mixed...
To develop and evaluate a system for reliable efficient individualized risk-based monitoring of cholesterol 11 other tests after kidney transplantation in children.We identified components that drive used quality improvement methods to implement interventions, including (1) schedules by dyslipidemia risk assigned each patient, (2) automated previsit decision support from our electronic medical record, (3) standardized work flow responsibility, (4) forwarding results providers. We measured...
Steroid-avoidance protocols have recently gained popularity in pediatric kidney transplantation. We investigated the clinical practice of steroid avoidance among 9494 transplant recipients at 124 centers between 2000 and 2012 Organ Procurement Transplantation Network database. The increased during study period demonstrated significant variability centers. From 2008 to 2012, 39% used <10% all discharged recipients. Twenty-one percent practiced 10–40% recipients, 40% >40% patients. Children...
Hypertension is highly prevalent in pediatric kidney transplant recipients and contributes to cardiovascular death graft loss. Improper blood pressure (BP) measurement limits the ability control hypertension this population. Here, we report multicenter efforts from Improving Renal Outcomes Collaborative (IROC) standardize improve appropriate BP patients.Seventeen centers participated structured quality improvement activities facilitated by IROC, including formal training methods. The primary...